Kalaoui M, Radhakrishnan S, al Shamali M, Hasan F, al-Nakib B
Gastroenterology Centre, Al Amiri General Hospital, Kuwait.
J Trop Pediatr. 1998 Dec;44(6):371-5. doi: 10.1093/tropej/44.6.371.
This report summarizes our retrospective analysis of 173 colonoscopic examinations performed on 159 children over a period of 9 years in Kuwait. Ninety-six children were males, with a male to female ratio of 1.5:1. The main indications for colonoscopy were rectal bleeding, polyps, and suspected inflammatory bowel disease. Examination was done under sedation or anaesthesia. One hundred and fifty-one (87 per cent) examinations were complete up to the caecum and 89 (51 per cent) up to the terminal ileum. The most common pathology was polyps in 42 children. All but one polyp were hamartomatous and mainly localized to the rectum and sigmoid colon. The majority had a single polyp. One child had adenomatous polyposis coli. One hundred and forty-two polyps were removed endoscopically with no complications. Inflammatory bowel disease was present in 34 (21 per cent) children (17 Crohn's disease, 11 ulcerative colitis, and 6 indeterminate colitis). Tuberculosis of the ileo-caecal region was diagnosed in two cases. Seven patients had rectal ulcers presenting as rectal bleeding. In 11 (7 per cent), the lesions were limited to the right side of the colon or terminal ileum. These results suggest that colonic pathology is not uncommon in children in Kuwait. The disease pattern is similar to that reported in western countries. As we have observed in adults, inflammatory bowel disease is seen in significant numbers among children in this region. In this survey we have observed a change in the disease frequency, Crohn's disease being more common that ulcerative colitis. Without adequate examination, the existence of inflammatory bowel disease and this possible changing pattern of disease would have gone unrecognized.
本报告总结了我们对科威特9年间159名儿童进行的173次结肠镜检查的回顾性分析。96名儿童为男性，男女比例为1.5:1。结肠镜检查的主要指征为直肠出血、息肉和疑似炎症性肠病。检查在镇静或麻醉下进行。151例（87%）检查至盲肠完成，89例（51%）至回肠末端完成。最常见的病理情况是42名儿童有息肉。除1例息肉外，其余均为错构瘤性息肉，主要位于直肠和乙状结肠。大多数为单个息肉。1名儿童患有家族性腺瘤性息肉病。142个息肉通过内镜切除，无并发症。34名（21%）儿童患有炎症性肠病（17例克罗恩病、11例溃疡性结肠炎和6例不确定性结肠炎）。2例诊断为回盲部结核。7例患者有直肠溃疡，表现为直肠出血。11例（7%）病变局限于结肠右侧或回肠末端。这些结果表明，结肠病变在科威特儿童中并不少见。疾病模式与西方国家报道的相似。正如我们在成人中观察到的，该地区儿童中炎症性肠病的发病率也很高。在本次调查中，我们观察到疾病频率有所变化，克罗恩病比溃疡性结肠炎更常见。如果没有充分的检查，炎症性肠病的存在以及这种可能变化的疾病模式将无法被识别。
